Raquel: 360-degree spinal fusion restored her spine's stability after years of pain

The origin: back pain radiating down the hip

Raquel is 44 years old. Two years ago she began to suffer severe back pain radiating down her hip. Far from easing, the pain grew progressively more intense until neurological symptoms appeared that alarmed her: her leg began to go numb, she noticed tingling, and occasionally it gave way on her.

"The pain kept getting more intense, until my leg started going numb. I had tingling and occasionally it gave way, it would not respond and I would fall."

A difficult diagnosis: from the digestive system to the spine

At first all the tests pointed to a different problem. Raquel moved between doctors and the initial investigations oriented the picture towards a digestive origin. A perineal hernia was considered, with a sensation that the intestine was descending, and the tests showed atrophy of the muscles responsible for holding the rectum in place.

The key came with a very thorough whole-body MRI, which revealed that the true origin of the problem was not the intestine but the spine. From that point the case moved into the domain of orthopaedics and neurosurgery, where further MRI scans gradually mapped out the full picture of what was happening.

The real cause: an unstable L4 compressing the nerves

The tests showed two severely deteriorated vertebrae; one of them, L4, was shifting forwards rather than staying fixed. That abnormal movement and the associated wear were affecting the nerves in the area. When those nerves were compressed, they stopped delivering the proper stimulus to the muscles that support the rectum.

Without that signal, the muscles gradually atrophied and lost strength, to the point where they could no longer hold the rectum, which explained the rectocele Raquel had been carrying. Everything was part of the same problem originating in the spine: an unstable column with repercussions far beyond the back.

An instability that took away her daily life

With the vertebra shifting, Raquel felt her entire back was unstable. She could do fewer and fewer things and walk less and less, because her leg gave way at any moment. That constant sense of insecurity gradually removed her from daily life.

"My whole back was completely unstable. I could walk less and less because my leg gave way. I was losing my daily life until I could do nothing at all."

Meeting Dr. Ferrés: an uncommon case studied in detail

Raquel came to Dr. Abel Ferrés, who was straightforward with her from the outset: this was an unusual case that needed thorough study before deciding anything. To understand exactly how the vertebra was shifting, he requested a dynamic X-ray to see the instability pattern of L4, the vertebra that needed to be fused.

"He told me clearly: we will look at what we can do, but I need to study this case very carefully because it is not common."

With all the tests confirmed, at the following appointment the specialist explained the entire procedure in detail.

The operation: an eight-hour procedure from the front and from the back

The aim was twofold: to open space in the vertebrae that were compressing the nerves and simultaneously to stabilise L4 to stop the displacement. Dr. Ferrés therefore proposed a 360-degree fusion: first an anterior approach to place the implant and all that was needed, then turning the patient to access from the rear, the most delicate part involving the affected nerves, release the structures and leave the vertebra correctly fused.

There was the possibility of dividing the operation across two days, but ultimately everything was performed in a single procedure.

"The surgery lasted eight hours and it was truly a complete success."

Waking up: regaining sensation in the leg

Raquel describes her immediate post-operative experience as something she will never forget. On waking in the recovery room, the first thing she did was check that she could bend her leg and that she could feel it again, a sensation she had not had for almost a year.

"I woke up and the first thing I did was see that I could bend my leg. I could feel it. A sensation I had not had for a year. I was very emotional."

She had no complications of any kind.

Recovery: walking again, step by step

Progress was rapid. Two days later she was walking along the ward corridor and, on the fourth day, she went home. Six months after the operation Raquel can walk for half an hour to three-quarters of an hour at a stretch. She knows she has to take it gradually, but faces each step forward with great enthusiasm.

"Two days later I was already walking along the ward. I was overjoyed to be able to walk."

Close-knit care that changed her life

Beyond the clinical outcome, Raquel highlights the human dimension of Dr. Ferrés, who addressed all her questions person to person, with an approachable, clear and honest manner.

"The relationship with Dr. Ferrés was like talking to a friend. He saved my life. Looking back two years, I am very happy with how I am now."